Humans ; Intervertebral Disc Displacement/surgery* ; Skull ; Lumbar Vertebrae/surgery* ; Blindness ; Treatment Outcome ; Intervertebral Disc Degeneration/surgery*

Female ; Humans ; Intervertebral Disc ; surgery ; Intervertebral Disc Displacement ; surgery ; Middle Aged

Anterior cervical fusion surgery is the first choice for spine surgeons in the treatment of cervical spine diseases. It has significant effects in treating cervical degenerative diseases, trauma and tumors and other cervical diseases. In anterior cervical fusion, it is necessary to use a distractor to properly distract the intervertebral space, so as to fully expose and relieve the compressive factors, restore the physiological height, curvature and stability of the lesion segment, and achieve the best surgical effect. However, there is currently no consensus on the standard distraction height for the intervertebral space during anterior cervical surgery. This article reviewsed the progress of intervertebral space height in anterior cervical fusion from three dimensions:the relationship between intervertebral space height and cervical disc degeneration mechanism, the selection of intervertebral space height during operation, the recovery of intervertebral space height and the postoperative effect, so as to provide theoretical basis and reference for spinal surgeons when performing intervertebral distraction during operation.
Cervical Vertebrae/surgery* ; Humans ; Intervertebral Disc/surgery* ; Intervertebral Disc Degeneration ; Neck ; Spinal Fusion ; Treatment Outcome

Humans ; Intervertebral Disc Displacement/therapy* ; Medicine, Chinese Traditional ; Intervertebral Disc ; Intervertebral Disc Degeneration ; Lumbar Vertebrae/surgery* ; Magnetic Resonance Imaging

Bone Resorption ; Cervical Vertebrae/surgery* ; Humans ; Incidence ; Intervertebral Disc/surgery* ; Intervertebral Disc Degeneration/surgery* ; Total Disc Replacement ; Treatment Outcome

Adult ; Female ; Humans ; Intervertebral Disc Chemolysis ; Intervertebral Disc Displacement ; surgery ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Recurrence

The modern surgical treatment of cervical degenerative disc disease can be traced back to the advent of anterior cervical decompression and fusion.With the emergence of fusion-related complications,different scholars have promoted the gradual transformation of cervical degenerative disc diseases from "fusion fixation" to "non-fusion reconstruction" through in-depth fusion with materials science,engineering mechanics and other disciplines.The innovation of this treatment concept is consistent with the original intention of "structural remodeling,functional reconstruction,maximum repair and reconstruction of the morphology and function of skeletal muscle system" in orthopedic bionic treatment,which is essentially in line with the "bionic alternative therapy" in orthopedic bionic therapy.This paper focuses on the surgical treatment of cervical degenerative disc diseases,reviews the development history of artificial cervical disc replacement,analyzes the evolution from orthopedic biomimetic therapy,and explores a new direction for the design of artificial cervical disc prostheses and the treatment of cervical degenerative disc diseases in the future.
Bionics ; Cervical Vertebrae/surgery* ; Diskectomy ; Follow-Up Studies ; Humans ; Intervertebral Disc/surgery* ; Intervertebral Disc Degeneration/surgery* ; Spinal Fusion ; Total Disc Replacement ; Treatment Outcome

OBJECTIVE: To explore the curative effect of surgical treatment for lumbar discogenic low back pain. METHODS: Forty-two patients with lumbar discogenic low back pain were treated with disc excision and lumbar interbody fusion: 12 of them were treated with posterior lumbar interbody fusion (PLIF), 30 with afront lumbar interbody fusion (ALIF). The clinical results were evaluated by pre- and post-operative visual analogue scale (VAS), and the fusion rates of the lumbosacral spine were evaluated by X-ray. RESULTS: The average follow-up period was 18 months, ranging from 6 to 36 months. Low back pain basically disappeared in 11 patients treated with PLIF, with mild back pain in one patient; VAS after the operation decreased significantly in comparison with that preoperatively (P<0.01). Low back pain basically disappeared in 28 patients treated with ALIF; VAS after the operation decreased significantly in comparison with that preoperatively (P<0.01). The fusion rate was 90% in patients treated with PLIF, and 93% in patients with ALIF. CONCLUSION Disc excision and interbody fusion is effective in the treatment of lumbar discogenic low back pain, but the operation indications should be paid attention to.
Adolescent ; Adult ; Female ; Humans ; Intervertebral Disc ; surgery ; Intervertebral Disc Displacement ; complications ; surgery ; Low Back Pain ; etiology ; surgery ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Spinal Fusion ; methods ; Treatment Outcome

OBJECTIVETo investigate retrospectively the clinical effects and recurrence rate of 143 cases who underwent one level discectomy and followed up more than 10 years. To evaluate the outcome of patients in groups of different operating age and extents of disc herniation, and analyse whether difference exists in each group.

METHODSThere were 143 patients (operation time from January 1996 to December 2000) including 80 males and 63 females, aged from 18 to 66 years old with an average of 37.85 years. The followed-up time was 10 to 15 years with an average of 12.7 years. Patients were divided into 3 groups depends on operating age: < 30 years old, 30 to 50 years old and > 50 years old; 87 patients who's pre-operative CT scan could be collected among 143 cases were divided into 3 groups depends on extents of disc herniation: I degree, II degrees, and III degrees. The final followed-up was obtained in 2011, to evaluate each group and the holistic clincal outcome with JOA scores and ODI scores, and observe whether there were difference between every groups; to judge the effects by patient himself with modified Macnab Criteria.

RESULTS(1) JOA scores pre-operation and final followed-up was 5.11 +/- 2.02 and 12.51 +/- 2.35 respectively; ODI scores pre-operation and final followed-up was 33.98 +/- 7.42 and 13.39 +/- 6.79 respectively. There were significant differences between pre-operative and final followed-up in JOA and ODI (P < 0.01). The excellent-good rate was 83.2% (119/143 ) according to modified Macnab Classification with recurrence rate of 6.3% at final follow-up. (2) Obvious difference was found in JOA scores in group who's age at operation less than 30 years old compared with other 2 groups at followed-up time, and no significant difference was found in JOA scores between other two groups ; no significant difference was found in ODI scores among the three groups. (3) Significant difference was found in JOA and ODI scores in group with III degrees lumbar disc herniation group compared with other 2 groups, and no statistical difference was found in clincal scores between other 2 groups.

CONCLUSION(1) Long-term followed-up of 143 cases prove mono-level lumbar discectomy is an option for disc herniation with good curative effect and lower recurrent rate, the technique should be the prior selection in dealing with patients with lumbar disc herniation. (2) 51% patients (19/37) in group under 30 years old endure persistent low back pain. (3) The long-term clinical effects in patients with severe disc protrution who underwent lumbar discectomy is worse than those patients with mild lumbar disc herniation.

Adolescent ; Adult ; Aged ; Female ; Follow-Up Studies ; Humans ; Intervertebral Disc ; surgery ; Intervertebral Disc Displacement ; surgery ; Laminectomy ; methods ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Retrospective Studies

BACKGROUNDDynesys dynamic stabilization system was first implanted in patients in 1994, and introduced to China in 2007. Therefore, it was a new technique for Chinese orthopedics and hence necessary to collect clinical data about Dynesys in China. The objective of this study was to report the preliminary results of Dynesys for the lumbar degenerative disease in China.

METHODSTwenty-seven patients were treated with the Dynesys between July 2007 and January 2009. The diagnosis included degenerative spondylolisthesis (12 cases), degenerative spinal stenosis (nine cases), and lumbar intervertebral disc herniation (six cases). Back pain and leg pain were evaluated using 100-mm visual analog scales (VAS). The Oswestry Disability Index (ODI) was used to evaluate the patients' function. The intervertebral disc height and range of motion at the operative level were taken on radiographs.

RESULTSAll the patients were followed-up, with an average of (22.40 ± 4.23) months (range 15-32 months). VAS of back pain and leg pain were improved significantly (P < 0.05) at follow-up. The ODI scores were reduced from (62.58 ± 12.01)% preoperatively to (15.01 ± 5.71)% at follow-up (P < 0.05). The preoperative mean height of the intervertebral disc was (11.21 ± 1.58) mm (range 8.5-13.8 mm) and mean was (10.10 ± 1.78) mm (range 7.0-13.4 mm) at follow-up (P < 0.05). The mean range of motion of the implanted segment was (6.00 ± 1.79)° (range 2.5-9.3°) preoperatively and (5.47 ± 1.27)° (range 2.9-7.8°) at follow-up (P = 0.11).

CONCLUSIONSThe preliminary results of Dynesys for the lumbar degenerative disease in China are similar to the published results of other countries. It can significantly improve the clinic symptoms and preserved motion at the level of implantation. However, the long-term follow-up data need to be collected.

Adolescent ; Adult ; Aged ; China ; Female ; Humans ; Intervertebral Disc Degeneration ; pathology ; surgery ; Intervertebral Disc Displacement ; pathology ; surgery ; Lumbar Vertebrae ; pathology ; surgery ; Male ; Middle Aged ; Treatment Outcome ; Young Adult